that unless these gaps are filled with research on vaccine safety, we will continue to have problems communicating uncertain risks.
Two suggestions were offered to avoid organizational bias and a conflict in the roles that some federal agencies and providers are asked to play. The first was that individuals providing information about the risks and benefits of vaccines be more open to other points of view, including seeking information from the National Vaccine Information Center. The second was that, in order to decouple the mission to prevent infectious disease through vaccination with the need to inform people of the risks of vaccines, an independent organization without a dual role should be the official source of the risk-benefit information.
Three major themes emerged during the workshop. First, risk communication is a dynamic process in which many participate, and these individuals are influenced by a wide range of circumstances, interests, and information needs. Effective risk communication depends on the providers' and recipients' understanding more than simply the risks and benefits; background experiences and values also influence the process. Good risk communication recognizes a diversity of form and context needs in the general population. Both the method and content of risk communication should reflect the goals of the communication, which could include advocacy, education, and development of a decisionmaking partnership (in any combination).
Second, the goal that all parties share regarding vaccine risk communication should be informed decisionmaking. Consent for vaccination is truly "informed when the members of the public know the risks and benefits and make voluntary decisions. The discussion of mandatory vaccination at the workshop suggested that it may interfere with informed consent and may damage trust and deter effective communication, and thus needs to be carefully weighed against its benefits. Other reasons for risk communication regarding vaccines are that (1) people appreciate receiving the information; it is a fundamental form of respect for persons, and shows that they are treated more equally in the decisionmaking process; (2) early recognition and treatment of side effects may reduce their consequences; and (3) identifying individual factors, such as immune deficiency, might influence the decision to vaccinate.
Finally, there is often uncertainty about estimates of the risks associated with vaccination. Risk communication is more effective when this uncertainty is stated and when the risks are quantified as much as science permits. Trust is a key component of the exchange of information at every level, and overconfidence about risk estimates that are later shown to be incorrect contributes to a breakdown